LAUREL KIETZMAN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****29

License Status

ACTIVE

Business

Title

First Name

LAUREL

Last Name

KIETZMAN

Business Name

LAUREL KIETZMAN MD

Original Issue Date

10/06/2010

Effective Date

04/06/2023

Expiration Date

07/31/2026

City

AURORA

State

Zip

60506

County

KANE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/06/2023